The Evangelical Lutheran Good Samaritan Society

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Practice address

602 Main St E
Mohall, ND 58761-4100

Phone

(701) 756-6831

Fax

(701) 756-6357

NPI assigned

Nov 8, 2005

Organization subpart

Yes

Parent organization

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETYAs reported in NPPES

Name

Ms. Raye Nae Nylander

Title

Cfo

Phone

(605) 362-3100

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• The Evangelical Lutheran Good Samaritan Society

  • Skilled Nursing Facility
  • Parshall, ND
  • NPI 1295716207
  NPPES parent name

Organizations this organization is a member of, according to the National Provider Directory.

• The Evangelical Lutheran Good Samaritan Society

  • Skilled Nursing Facility
  • Sioux Falls, SD
  • NPI 1952385015
  NPD member Member Of

Part of

Red Oak Iowa Good Sam C

Locations

• Good Samaritan Society - Mohall Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 28, 2021.

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638057600000",
    "number": "1861473852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5038",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175038",
            "telephone_number": "605-362-3100",
            "fax_number": "605-362-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 MAIN ST E",
            "city": "MOHALL",
            "state": "ND",
            "postal_code": "587614100",
            "telephone_number": "701-756-6831",
            "fax_number": "701-756-6357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY",
        "enumeration_date": "2005-11-08",
        "last_updated": "2021-11-28",
        "certification_date": "2021-11-28",
        "status": "A",
        "authorized_official_last_name": "NYLANDER",
        "authorized_official_first_name": "RAYE NAE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "605-362-3100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30173",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4721",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30741",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Good Samaritan Society - Mohall",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Good Samaritan Society - Mohall",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peggy Ring
• Loretta Scott, LPN
• Melanie Ray Skar, PT
• Mary Smith
• Ruth A Stanley, NP-C
• Sarah Irene Tracy
• Amanda Marie Wallace, LCSW
• White Drug Co of Jamestown Inc

• All providers in Mohall, ND
• Skilled Nursing Facility in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.